Left anterior descending coronary artery aneurysm and fistulization to the left pulmonary artery: a case report

Nazmiye Selçuk Kapısız, Hasan Fahri Kapısız, Ertan Yücel

Ankara Dışkapı Eğitim Hastanesi Kalp ve Damar Cerrahisi Kliniği, Ankara

Congenital fistulae of the coronary arteries are rare. A 62-year-old woman was admitted with palpitation and atypical chest pain. She underwent echocardiographic examination, cardiac catheterization, and coronary angiography, which revealed a coronary artery arteriovenous fistula, 20x20 mm in size, originating from the left anterior descending coronary artery and draining into the left pulmonary artery. Open surgical repair under cardiopulmonary bypass was planned. At surgery, three aortic aneurysms were also noted, measuring 20x20 mm, 10x10 mm, and 30x20 mm. The aneurysms were resected, the first diagonal was ligated, the pulmonary fistula was repaired, and the internal mammary artery was anastomosed to the left anterior descending artery. Postoperative angiography showed successful closure of the fistula, a competent anastomosis, and normal coronary anatomy.

Keywords : Arteriovenous fistula/congenital/surgery; coronary aneurysm/surgery; coronary artery bypass; coronary vessel anomalies/ surgery

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